Department of Hepatobiliary and Pancreatic Surgery, First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing, 314000, Zhejiang, China.
Department of Health Management Center, First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing, 314000, Zhejiang, China.
World J Surg Oncol. 2023 Sep 25;21(1):303. doi: 10.1186/s12957-023-03198-0.
The Naples prognostic score (NPS) is a comprehensive prognostic model that includes inflammatory and nutrition-related indicators and is increasingly used as a prognostic score for various malignant tumors. Given its predictive effect on prognosis in patients with gallbladder cancer, it is currently unclear. This study aimed to investigate the role of preoperative NPS in predicting prognosis in gallbladder cancer surgery patients.
A retrospective analysis was performed for 135 patients who underwent radical surgery for gallbladder cancer without preoperative treatment between March 2011 and January 2020. NPS was calculated by measuring the preoperative total cholesterol value, serum albumin value, neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). They were then divided into 3 groups (groups 0, 1, and 2) based on NPS scores. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Univariate and multivariate Cox proportional hazards models were used to identify independent prognostic factors. Plot time-dependent receiver operating characteristic (ROC) curves to compare the prognostic value of scoring systems. Finally, a nomogram model was developed with independent prognostic factors.
Multivariate analysis showed that NPS was an independent risk factor affecting OS (HR = 3.417, p < 0.05). The time-dependent ROC curve results showed that NPS had a better predictive value on survival prognosis than other indicators. The nomogram constructed according to independent factors such as NPS has a good predictive ability for OS.
As a simple and reliable tool, the NPS has important predictive value in the survival prognosis of gallbladder cancer patients. The nomogram model constructed by NPS will help determine prognosis and make individualized treatment decisions.
那不勒斯预后评分（NPS）是一种综合预后模型，包含炎症和营养相关指标，越来越多地用于各种恶性肿瘤的预后评分。鉴于其对胆囊癌患者预后的预测作用，目前尚不清楚。本研究旨在探讨术前 NPS 预测胆囊癌手术患者预后的作用。
回顾性分析了 2011 年 3 月至 2020 年 1 月期间未经术前治疗行根治性胆囊癌切除术的 135 例患者。通过测量术前总胆固醇值、血清白蛋白值、中性粒细胞-淋巴细胞比值（NLR）和淋巴细胞-单核细胞比值（LMR）来计算 NPS。然后根据 NPS 评分将患者分为 3 组（组 0、1 和 2）。采用 Kaplan-Meier 法和对数秩检验进行生存分析。采用单因素和多因素 Cox 比例风险模型识别独立预后因素。绘制时间依赖性接受者操作特征（ROC）曲线比较评分系统的预后价值。最后，使用独立预后因素开发了列线图模型。
多因素分析显示，NPS 是影响 OS 的独立危险因素（HR=3.417，p<0.05）。时间依赖性 ROC 曲线结果表明，NPS 对生存预后的预测价值优于其他指标。根据 NPS 等独立因素构建的列线图对 OS 具有良好的预测能力。
作为一种简单可靠的工具，NPS 对胆囊癌患者的生存预后具有重要的预测价值。通过 NPS 构建的列线图模型将有助于确定预后并做出个体化的治疗决策。
